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. Conception, design, intellectual and scientific content of the study; analysis and interpretation of data; manuscript writing; critical revision. ABSTRACT PURPOSE:To evaluate the expression profile of genes related to Toll Like Receptors (TLR) pathways of human Primary Epidermal keratinocytes of patients with severe burns. METHODS:After obtaining viable fragments of skin with and without burning, culture hKEP was initiated by the enzymatic method using Dispase (Sigma-Aldrich). These cells were treated with Trizol® (Life Technologies) for extraction of total RNA. This was quantified and analyzed for purity for obtaining cDNA for the analysis of gene expression using specific TLR pathways PCR Arrays plates (SA Biosciences). RESULTS:After the analysis of gene expression we found that 21% of these genes were differentially expressed, of which 100% were repressed or hyporegulated. Among these, the following genes (fold decrease): HSPA1A (-58), HRAS (-36), MAP2K3 (-23), TOLLIP (-23), RELA (-18), FOS (-16), and TLR1 (-6.0). CONCLUSIONS:This study contributes to the understanding of the molecular mechanisms related to TLR pathways and underlying wound infection caused by the burn. Furthermore, it may provide new strategies to restore normal expression of these genes and thereby change the healing process and improve clinical outcome.

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inguinal nodes 3 hours following injection, tortuous collateral lymphatic channels, and dermal backflow consistent with lymphedema. Arrows indicate inguinal nodes, black arrowheads show tortuous lymphatic channels and dermal backflow, and white arrowheads mark the feet where the radiolabelled tracer was injected.

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Background Lower limb injuries are related to important disability to deal with environment. Socioeconomic characteristics also must be considered since they lead to a particular trauma profile. This association is necessary to guide control measures to prevent morbidity and mortality. Study design In the region, the human development index (HDI) varies from 0.772 to 0.804), per capita income varies from 1.62 to 2.36 (minimum wage) and the average years of study in the population was 6.5 years. Data collected from 334 admitted trauma patients between 2011 and 2012 at Hospital Pirajussara, a tertiary reference center in São Paulo, Brazil, linked to the Federal University of São Paulo, Paulista School of Medicine (UNIFESP-EPM) compiled the following parameters: length of stay, age, sex, mechanism of injury and mortality, which was associated with the local characteristics and data from the existing literature. The environment characteristics surrounding the hospital are of slums without adequate work conditions. Results Domestic falls were the most important mechanism of injury (50.8%), affecting mainly elderly people at the rate of 33.5% with femur fractures. Traffic accidents involved 27.2% of patients, 71.4% of them caused by motorcycle. Seventy-seven percent of motorcycle accidents involved young drivers with lower leg injury (69.2%) and hip/thigh injury (26%). Conclusion Results demonstrate that most lesions are motivated by domestic falls and are strongly correlated to elderly patients, while young patients are more inclined to suffer traffic accidents, mostly associated with motorcycles. Considering this peculiar epidemiological profile is possible to intervene through policy approaches, such as safer road infrastructure and enforcement of laws to decrease risky behavior, and third age public healthcare strategies allied to better structured homes, using assistive devices as handrails for stairways and removing hazards from passage. How to cite this article Loreto TM, Cezillo MVB, Müller BR, Ribeiro RC, Andrade AA, Abib SCV. Lower Limb Injuries and Socioeconomic Influences in a Region of a Tertiary Hospital in São Paulo, Brazil. Panam J Trauma Crit Care Emerg Surg 2014;3(2):47-52.